define("pages/jbxxJkjc/jbxxJkjc_form.html", [],
    '<div class="awd-form-placeholder"></div>\
     <div class="awd-form-panel">\
         <div class="row">\
             <div class="col-sm-12 awd-form-header">健康情况登记表</div>\
         </div>\
         <div class="row form-inline awd-form-tools">\
             <div class="col-sm-6">\
                 <div class="form-group">\
                     <label class="control-label">填表人：</label>\
                     <p class="form-control-static">{{tbr}}</p>\
                 </div>\
             </div>\
             <div class="col-sm-6 text-right">\
                 <div class="form-group">\
                     <label class="control-label">填表日期：</label>\
                     <p class="form-control-static">{{tbrq}}</p>\
                 </div>\
             </div>\
         </div>\
         <form class="form-inline awd-input-form awd-form">\
             <input type="hidden" name="tbr" value="{{tbr}}">\
             <input type="hidden" name="tbrq" value="{{tbrq}}">\
             <input type="hidden" name="rybh" value="{{data.rybh}}">\
		 	<input type="hidden" name="gcbh" value="{{data.gcbh}}">\
             <input type="hidden" name="ywlcid" value="{{data.ywlcid}}">\
             <input type="hidden" name="taskid" value="{{data.taskid}}">\
          <div class="jbxx-placeholder"></div>\
             <div class="row">\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">身高（厘米）</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="sg" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">体重（公斤）</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="tz" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">足长（码）</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="zc" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">心脏</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="xl" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">血压</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="xy" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">检查人员</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="jcr" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">体表状况</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="tbzk" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">既往病史</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="brbs" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">有何传染病</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="crb" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">家庭病史</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="jtbs" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">手术史</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="sss" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">外伤史</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="wss" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">自述症状</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="zszz" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">伤病情</label><span class="required">*</span></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="sbq" class="form-control" required></textarea></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">健康状况</label><span class="required">*</span></div>\
                 <div class="col-sm-10 awd-input-field"><input type="text" name="jkzk" class="form-control awdSelect" code=\'JKZK\' required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">医生意见</label><span class="required">*</span></div>\
                 <div class="col-sm-10 awd-input-field"><input type="text" class="form-control" name="ysyj" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">检查日期</label><span class="required">*</span></div>\
                 <div class="col-sm-2"><input type="text" name="jcrq" class="form-control easyui-datebox" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">医生签名</label><span class="required">*</span></div>\
                 <div class="col-sm-2 awd-input-field"><input type="text" name="ysqm" class="form-control" required></div>\
                 <div class="col-sm-2 awd-label-feild"><label class="control-label">签名日期</label><span class="required">*</span></div>\
                 <div class="col-sm-2"><input type="text" name="qmrq" class="form-control easyui-datebox" required></div>\
                 <div class="col-sm-2 awd-label-feild" style="height:60px;line-height:60px;"><label class="control-label">备注</label></div>\
                 <div class="col-sm-10" style="height:60px;"><textarea name="bz" class="form-control" ></textarea></div>\
             </div>\
         </form>\
 \
         <div class="row text-center form-submit-tools">\
             <a href="javascript:void(0)" class="easyui-linkbutton save-button" iconCls="icon-ok" style="margin-right: 30px">保存</a>\
             <a href="javascript:void(0)" class="easyui-linkbutton close-button" iconCls="icon-cancel">关闭</a>\
         </div>\
     </div>\
         ');